World AIDS Day Commemoration

It is my privilege, as the donor countries’ representative, to join you as we commemorate World AIDS Day here in Dar es Salaam. We stand here together today to mourn the world’s losses as a result of HIV and to celebrate its many brave heroes, who have fought in ways big and small against this disease, all with one goal in mind: to win the fight against this disease by ensuring an AIDS-free generation.

To win we must fight together against AIDS in Tanzania! In this effort, we need to acknowledge the many significant achievements in the fight against HIV and AIDS under the leadership of His Excellency, President Kikwete: these achievements include: significantly decreasing HIV prevalence among adults; creating a strong program, which includes safe male circumcision as a key approach for HIV prevention; and increasing antiretroviral coverage so that now nearly 70% of adults who need coverage in Tanzania (up from 46%) have it. More good news: In the past ten years, new infections dropped by 42%. These figures are certainly impressive, but numbers are just numbers…here is what it all adds up to: As a result of these improvements, Tanzania, for the first time, has now reached a dramatic tipping point, with more people starting treatment than the number of people becoming infected with HIV. This is a sure sign that we are moving the ball closer to the goal of an AIDS-free generation.

We are winning against this disease. Now is the time to act! All of this hopeful progress is the product of a warm and collaborative relationship among the Government of Tanzania, development partners, civil society, affected populations, and other stakeholders.

Yet there is still much work to be done: from needing a better health care system, to improving the delivery of needed drugs, to having more doctors and nurses, to ensuring that all Tanzanians receive quality and stigma-free care and treatment regardless of how or when they contracted HIV. Even with so many areas that cry for our attention, I’d like to use these brief comments to focus our hearts and minds on one particular part of the challenge.

As a mom of four children, it is easy to see where all of our futures lie, and that is the next generation. To have a generation free of AIDS, we need to focus more on our little ones – sadly, it is too late for our generation to be AIDS free, but it isn’t too late for theirs. To all my fellow parents out there today, I must say I think we are letting our children down. While the percentage of Tanzanian children who need HIV treatment and receive it has doubled in recent years – and that must be commended – treatment rates are still too low: of Tanzanian children who need treatment, only one child in four receives it.

To win, we must do more for our children. All infants and children, our dearest treasures, need to be tested for HIV, and those found to be positive must be given life-saving treatment. We also need to address barriers to HIV testing among teenagers and older children, and ensure that they receive full services and special support. On behalf of the development partners, I urge us all to place a greater emphasis on integrating HIV into child survival programs, including the early infant diagnosis and early treatment. We also need to shift the way we use health professionals to expand opportunities for treatment, particularly in rural areas, and we need to ensure that all Tanzanians have access to quality health services.

We must also acknowledge that Tanzania cannot adequately scale up HIV care and treatment – particularly for children – without broadening the roles of health care providers. Specifically, given that nurses are more available than doctors, especially at rural sites where many children could receive treatment and other care, nurses can play a much greater role in HIV treatment initiation and monitoring.

To win, Tanzania must have more nurses and doctors. We need to focus as well on other preventable root causes of the spread of HIV, such as the impact of sexual violence.

Tanzania is one of the first countries in Africa to undertake a national study specifically on violence against children – and I commend you for this work. But the results are heartbreaking: this study demonstrated that nearly one out of every three Tanzanian girls under 18 has experienced sexual violence, including rape and attempted rape. This sexual violence impacts so many aspects of a child’s life, including an increased risk of acquiring HIV.

And this terrible trend against girls continues as they grown to adulthood. Gender-based violence (GBV) is a critical issue that disproportionately affects women and children in Tanzania. While we are delighted to see HIV prevalence over the past ten years decrease among men, I am sad to note there has been no decrease among women. Gender-based violence is contributing to this alarming trend, and it is made clear through the last Tanzania Health Survey that established that almost half of married women in Tanzania experienced physical or sexual violence from an intimate partner in their lifetime.

We value the girls of Tanzania – and the women they become – too much for this trend to continue.

To win, we must end violence against women and children. Of course addressing these challenges requires resources, so I cannot conclude my remarks without addressing the critical need to mobilize domestic resources for the HIV/AIDS response for all Tanzanians. Yes, as donors we stand by you and share your goals. We are your steadfast partners, seeking ways to help with many of the challenges we’ve discussed today. But as we watch our neighbors to the South transitioning both management and financing of HIV programs to their governments, Tanzania’s HIV/AIDS budget continues to be highly donor dependent. There is a need for more deliberate and concerted efforts to mobilize internal resources. We support the planned implementation of the new Tanzania AIDS Trust Fund, and we must all take responsibility for its success. In addition, we urge the government to continue to identify other sources of revenue, including newly discovered natural resources, and devote them to the Health Sector overall.

We all envision a future where Tanzania achieves middle income status, but to make that future a reality we must call upon the government and all of our partners to lay the groundwork for that vision now!

To win, natural resources money must go into health. It will be possible to achieve a Tanzanian generation free of HIV when everyone – donors, government, mothers and fathers – contributes to the national response under the leadership of TACAIDS and in collaboration with the highest levels of government throughout this great country. The Development Partners Group would like to assure you of our continued commitment to the government of Tanzania and the Tanzanian people – and particularly to Tanzanian children.

We can win, we are winning, and together we can save future generations. With your permission, your Excellency, I would like to end with a quote from the father of the nation: “It is possible if everyone plays their part.”